AB0287 RHEUMATOID ARTHRITIS PATIENTS WITH INTERSTITIAL PNEUMONIA NEED APPROPRIATE TREATMENT ENHANCEMENT TO RECOVER FROM FRAILTY: A MULTICENTER RETROSPECTIVE OBSERVATIONAL STUDY
Authors: Y. Ohashi, N. Takahashi, M. Suzuki, Y. Sobue, R. Sato, M. Maeda, D. Kihira, K. Kishimoto, K. Terabe, S. Asai, S. Imagama
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Frailty is a common geriatric syndrome that embodies an elevated risk of catastrophic health and physical function declines among older adults [1]. Rheumatoid arthritis (RA) is an autoimmune disease that causes synovitis in the joints, resulting in joint deformity with a high prevalence (0.5-1.0% in Japan) [2]. Japan is one of the world's most rapidly aging societies [3], and older RA patients are generally at a greater risk of frailty than the general population. Most patients with comorbidities such as pulmonary, renal, and liver dysfunction are more prone to become frailty in the short term than healthy people [4], as well as poor control of disease activity in RA patients [5]. Against this background, the present study aimed to investigate factors associated with frailty in RA patients, including their comorbidities. <h3>Objectives</h3> This study investigates factors associated with frailty in RA patients. <h3>Methods</h3> 656 RA patients were evaluated from our observational study data in 2022. Of the patients, 152 were frailty, and 504 were not frailty assigned to the frailty group and the non-frailty group, respectively. Both patient characteristics were compared in univariate analysis. The factors associated with frailty were assessed by logistic regression analysis. As a sub-analysis, patients who have Interstitial pneumonia (IP) history and patients who do not were assigned to the IP (n =102) and non-IP (n =554) groups, respectively, to clarify differences between both groups. <h3>Results</h3> The frailty group was older (mean: 73.6 vs. 66.8 years) and had a higher DAS28-ESR (mean: 3.67 vs. 2.66) than the non-frailty group. DAS28-ESR (OR: 1.85, P&lt;0.001) and IP history (1.74, P =0.043) were associated with frailty (Table 1). The IP group was older (mean: 73.3 vs. 67.5 years), had a higher DAS28-ESR (mean: 3.30 vs. 2.80) (Figure 1 A), a higher HAQ-DI (mean: 0.32 vs. 1.19) (Figure 1 B), lower use of methotrexate (MTX) (26,5 vs. 62.9%), and higher use of steroid (44.1 vs. 26.8%) than the non-IP group. There was no difference in the use of biological and targeted synthetic disease-modifying antirheumatic drugs (b/ts-DMARDs) between both groups (38.3 vs. 37.3%) (Figure 1 C). The IP group had a higher frailty proportion than the non-IP group (20.6 vs. 37.3%) (Figure 1 D). <h3>Conclusion</h3> DAS28-ESR and IP history were associated with frailty in RA patients. Most RA patients with IP had frailty with insufficient treatments, i.e., low use of MTX, high use of steroid, and low use of b/ts-DMARDs. They might recover from frailty through appropriate control of disease activity using b/ts-DMARDs, which are easy to use for patients with comorbidities. <h3>References</h3> [1] Buchner DM, Wagner EH. Preventing frail health. Clin Geriatr Med1992 Feb;8(1):1-17. [2] Silman AJ, Pearson JE. Epidemiology and genetics of rheumatoid arthritis. Arthritis Res2002;4 Suppl 3(Suppl 3): S265-72. [3] Kono S. [Demographic analysis of the aging society: the case of Japan]. Jinko Mondai Kenkyu1985 Jul (175):16-30. [4] Damiano C, Onder G, Zazzara MB, Carfì A, Zucchelli A, Marengoni A, et al. Frailty, multimorbidity patterns and mortality in institutionalized older adults in Italy. Aging Clin Exp Res. 2022:1-8. [5] Furuya T, Oh K, Ikari K, Inoue E, Tanaka E, Yamanaka H, et al. Factors associated with frailty in Japanese patients with rheumatoid arthritis: results from the Institute of Rheumatology Rheumatoid Arthritis cohort study. Clin Rheumatol. 2022;41(2):405-10. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.